Field of the Invention
Provided herein are patient-specific surgical devices that provide a stable fitted position for use in shoulder surgery, fitting within a typical surgical incision. The patient-specific surgical devices may be used for various purposes including for use as or with a shoulder guide.
Description of the Related Technology
Conventional orthopedic prostheses, guides and implants have been in use for many years with considerable success. The use of custom designed prostheses, guides and implant components based on the patient-specific anatomy has moreover overcome many shortcomings of the older designs. Such patient-specific devices can be developed using commercially available software. Typically such devices are used for orthopedic interventions to the spine, hip, shoulder, knee and/or radius. Patient-specific devices available on the market include patient-specific knee replacement prostheses, patient-specific femoral and tibia cutting blocks, distal radius drilling, cutting templates, etc. At present, there exists an increasing amount of surgical interventions that benefit from the use of these medical image based patient specific surgical devices as described in patent applications US 2005/0203528 A1 and EP 1 486 900 A1, for instance.
While patient-specific devices such as guides are now typically used to accurately place pins, guide bone cuts or insert implants during orthopedic procedures, the correct positioning of these patient-specific devices remains a critical factor with important impact on the outcome of the procedure.
Currently, the patient-specific surfaces of such devices are created based on surgical exposure, thereby assessing which anatomical features are accessible during the surgery. However, based on these features alone, the stability of the patient-specific device is relatively unknown. Typically, a multitude of patient-specific devices with different patient-specific surfaces are created by combining different sections of the patient's anatomy and subjectively evaluating the stability of each, thereby further developing the patient-specific device and improving the stability. This is a very inefficient method because the number of surface combinations that need to be assessed is high and the patient-specific devices, or at least a part thereof, need to be physically produced before the stability can be analyzed. Furthermore, the stability of these devices can only be measured on a subjective level whereas inter- and intra-user variability should also be taken into account when evaluating the guide surface combinations. Also the exact patient-specific surface varies for every patient such that typically a group of example anatomies is used to evaluate stability.
When performing medical and surgical procedures on and around the shoulder joint, and specifically on and around the glenoid, it is crucial to provide surgical instruments having a high accuracy and stability. Typical surgical instruments for these types of procedures utilize some of the anatomic regions of the glenoid, such as the anterior surface of the glenoid and the glenoid face. Retractors for these types of surgical procedures typically fit onto the posterior side of the glenoid as well. While the anterior surface of the glenoid and the glenoid face are commonly used for engaging with the surgical instruments, these anatomical regions do not provide the surgical tools with an acceptable accuracy and stability.
Accordingly, there is a need for improved patient-specific devices for performing shoulder surgery.